耳下腺原発癌肉腫例

A case of carcinosarcoma of the parotid gland

I．はじめに

　癌肉腫（carcinosarcoma）は悪性の上皮成分と悪性の間葉成分からなる腫瘍で，全唾液腺腫瘍の0.04～0.16％，全悪性唾液腺腫瘍の0.4％と非常に稀な腫瘍である^1）。組織学的には高悪性度の腫瘍に分類されており，その予後はきわめて不良である^2）。

　今回われわれは耳下腺に発生した癌肉腫を治療する機会を得たので，その臨床経過を述べるとともに若干の文献的考察を加えて報告する。

　A 79-year-old man was complaning of a progressive swelling of the right parotid gland associated with right facial-nerve paralysis. MRI showed a tumor in the right parotid gland without cervical lymph node metastasis. He underwent right total parotidectomy combined with right neck dissection. Surgical specimens of tumor revealed carcinosarcoma. After the surgery, the patient received radiotherapy at a dose of 60Gy. Lung metastasis was found 4 months after surgery, and he was treated by oral administration of TS-1^®. Although the lung metastasis did not respond to TS-1^®, his performance status remained well until the time of death, 1 year 7 months after surgery. TS-1^® appeared contributing to the patient's prolonged survival to some extent.